[Iontophoresis in the conservative treatment of Peyronie's disease: preliminary experience].
In Peyronie's disease an early "peri-vasculitic" phase and a late "sclerogenic" one are described. In the former, conservative management is believed useful; unfortunately it is empirical concerning treatment modalities, drugs and administration routes, due to the poor pathogenetic knowledge of the disease itself. The Authors report on a preliminary experience based on iontophoresis, that is the drugs' ions direct transport from a solution into the tissues by means of a local electric field. 15 patients (47 to 64 years old, mean 55) all with penile recurvatum due to a well (physically and U.S.) documented Peyronie's plaque, and all but one with normal stiffness during erection, were submitted to the following therapeutic schedule: 3 sessions a week for three weeks; in each session (20 minutes) 10 mg verapamil and 4 mg dexamethasone are administered; the iontophoretic equipment delivers a 3 mA current; the active electrode, shaped as a small cup is placed on the penile skin above the plaque; the other electrode is set on one thigh. At a mean 5 months follow up (3-10 months) penile pain during erection disappeared in 66% patients, recurvatum diminished in 53%, and the plaque was reduced in size and/or was softened in 40% of the cases. No patient worsened nor became impotent during the treatment. The contextual improvement of all three above mentioned parameters (pain-recurvatum-physical examination) was observed in 26% of patients (versus 13% in a previous series treated by the Authors by drug peri-plaque injections). Although a longer follow up is necessary before drawing conclusions about the iontophoretic approach to the Peyronie's disease, the Authors wish to stress two main advantages of this therapeutic modality: absence of pain; absence of local trauma, in order to avoid local sclerogenic stimuli, which could perpetuate the hardening process.
Treffiletti
S
S
Divisione di Urologia, Azienda Ospedaliera SS. Antonio e Biagio e C. Arrigo, Alessandria.
Annoscia
S
S
Montefiore
F
F
Boccafoschi
C
C
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000188:drug therapy*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage*
D000893:Anti-Inflammatory Agents; D014665:Vasodilator Agents; D003907:Dexamethasone; D014700:Verapamil
La iontoforesi nel trattamento conservativo della malattia di La Peyronie: esperienza preliminare.